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With help from international donors,Congo introduced a new vaccine this month in an effort to save more of its babies from pneumococcal disease.

The donors and the country’s health minister, Dr. Victor Makwenge Kaput, acknowledged that the success will be hard to achieve. Congo is one of Africa’s largest and poorest countries. Vast stretches lack not just electricity and refrigeration, but paved roads. It has the world’s second-highest rate ofinfant mortality (after Chad). Its eastern provinces are convulsed by fighting that mixes local tribal hostilities, rival Hutu and Tutsi militias from Rwanda, warlord armies and efforts to control areas containing diamonds and other minerals.

The pneumococcus bacterium, which can cause fatalpneumonia,meningitis orsepsis, kills about 500,000 children under the age of 5 each year worldwide; more than 125,000 of them are in Congo, according to a 2004 study by Unicef, which found that onlymalaria killed more Congolese youngsters. At first, the new vaccine (given at a health center in Rwanda, above) is being rolled out only in the capital, Kinshasa, and it will be extended to just two of the Congo’s 11 provinces.

In the last six months, pneumococcal vaccine has been introduced in Guyana, Kenya, Mali, Nicaragua, Sierra Leone and Yemen, through theGlobal Alliance for Vaccines Initiative, which has received more than $2 billion from Britain, Canada, Italy, Norway, Russia and the Bill & Melinda Gates Foundation. The alliance is seeking another $4 billion to reach more countries with this vaccine and a rotavirus vaccine againstdiarrhea.